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Investigators Discover Potential Indicator for Chronic Fatigue Syndrome

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By Source: Annals of Allergy, Asthma and Immunology • • November 12, 1999

CHICAGO, ILL. - The discovery of a potential indicator for chronic fatigue syndrome is among new findings presented at the American College of Allergy, Asthma and Immunology's (ACAAI) Annual Meeting in Chicago. Chronic fatigue syndrome (CFS) is a debilitating disorder that causes unexplainable tiredness or lack of energy. It affects more than 14 million Americans, occurring mainly in adults aged 20 to 40 years and in twice as many women as men.

"Currently, the diagnosis of CFS involves a lengthy procedure of eliminating other possible causes of severe fatigue lasting more than six consecutive months,," said ACAAI Past President Joseph A. Bellanti, M.D., of Georgetown University Medical Center in Washington, D.C. "Hopefully this data will provide a predictive marker of CFS which will help unravel the diagnosis and treatment of this perplexing disorder."

Investigators used data from a double blind placebo controlled study published February 1999, in the ACAAI'S scientific journal, "Annals of Allergy, Asthma and Immunology." The study reported subjects taking a nutritional supplement ENADA) - a stabilized oral absorbable form of nicotinamide adenine dinucleotide (NADH) - were four times more likely to show an improvement in CFS symptoms than those taking a placebo.

According to Dr. Bellanti, the follow-up study testing urinary concentrations in 20 of the CFS patients found that 75 percent showed elevated levels of a major breakdown product of serotonin, known as 5-HIAA. When treated with NADH, 70 percent of the patients returned to normal range, whereas in the placebo subjects, 70 percent retained elevated or increasing levels.

"The results of this study suggest that the measurement of urinary 5-HIAA may not only serve as a useful predictive marker of disease activity in CFS patients, but also may provide an objective measure of improvement following therapy with NADK," said Dr. Bellanti.

The Centers for Disease Control and Prevention (CDC) defined criteria for the diagnosis of chronic fatigue syndrome. Unexplained, debilitating fatigue of at least six month duration must be present, along with four or more of the following symptoms: neurocognitive dysfunction, muscle pain, sore throats, headaches, feeling of being sick or of physical discomfort after exertion, joint pain, sleep disturbances, or swelling and tenderness of lymph nodes.

For assistance in locating an allergist-immunologist, call the ACAAI toll-free number (800) 842-7777 or visit its public web site at

The ACAAI is a professional medical organization comprised of 4,100 qualified allergists-immunologists and related health care professionals. The College is dedicated to the clinical practice of allergy, asthma and immunology through education land research to promote the highest quality of patient care.

NOTE: Full-text articles published in "Annals of Allergy, Asthma & Immunology" are available free to media on the Internet at through December 2000. Thereafter, access will be limited to subscriptions.

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